Prevalence of carbapenem-resistant gram-negative bacteria among neonates suspected for sepsis in Africa : a systematic review and meta-analysis

DATA AVAILABITY STATEMENT: All generated data and research materials used during this systematic review and meta analysis are available from paper and supplementary material.BACKGROUND: The emergence and rapid spread of gram-negative bacteria resistant to carbapenems among newborns is concerning on a global scale. Nonetheless, the pooled estimate of gram-negative bacteria resistant to carbapenem that cause neonatal sepsis in developing nations remains unknown. Thus, this study aimed to determine the combined prevalence of gram-negative bacteria resistant to carbapenem in African newborns who were suspected of having sepsis. METHODS: All studies published from January 1, 2010, up to December 30, 2023, from PubMed, Science Direct, Scopus electronic databases, and the Google Scholar search engine were researched. Isolates tested for carbapenem from neonates with sepsis, English language papers conducted in Africa, and cross-sectional and cohort studies papers were included. Using PRISMA guidelines, we systematically reviewed and meta-analyzed studies that assessed the prevalence of carbapenem-resistant gram-negative bacteria. The “Joanna Briggs Institute” was used critically to evaluate the quality of the included studies. The data analysis was carried out using STATA™ version 17. Heterogeneity across the studies was evaluated using Q and I 2 tests. The subgroup analysis was done and, funnel plot and Egger’s regression test were used to detect publication bias. A sensitivity analysis was conducted. RESULTS: All 36 studies were included in the meta-analysis and systematic review. The pooled prevalence of carbapenem resistance in Africa was 30.34% (95% CI 22.03–38.64%). The pooled estimate of gram-negative bacteria resistant to imipenem, and meropenem was 35.57% (95% CI 0.67–70.54%) and 34.35% (95% CI 20.04% – 48.67%), respectively. A. baumannii and Pseudomonas spp. had pooled prevalence of 45.9% (95% CI 33.1–58.7%) and 43.0% (95% CI 23.0–62.4%), respectively. Similarly, Pseudomonas spp. and A. baumannii also exhibited strong meropenem resistance, with a pooled prevalence of 29.2% (95% CI 4.8–53.5%) and 36.7% (95% CI 20.1–53.3%), respectively. E. coli and K. pneumoniae were the two most common isolates. CONCLUSION: There should be urgent antimicrobial stewardship practices, strengthened surveillance systems and effective treatment for neonates with sepsis. There was remarkable variation in resistance across the continent.https://bmcinfectdis.biomedcentral.com/Medical MicrobiologySDG-03:Good heatlh and well-bein

Statistical analysis on the incidence and predictors of death among second-line ART patients in public hospitals of North Wollo and Waghemira Zones, Ethiopia, 2021

Abstract Acquired immune deficiency virus, caused by the human immunodeficiency virus, is a significant global health concern. Sub-Saharan Africa particularly Ethiopia faces a high prevalence of human immunodeficiency virus. In low-income settings like Ethiopia, early mortality rates are elevated due to severe opportunistic infections and advanced disease at Anti-retroviral treatment initiation. Despite available treatments, delayed treatment initiation among Human Immunodeficiency Virus -infected individuals in Africa, including Ethiopia, leads to disease progression and increased mortality risk. This study aimed to identify the factors contributing to the death of HIV patients under treatment at second line regimen in public hospitals of North Wollo and Waghemira Zones. A retrospective cohort study with 474 patients was conducted in selected hospitals of North Wollo and Waghemira Zones. A parametric Weibull regression model was employed, and the adjusted hazard ratio served as the measure of association. Variables significantly affected the outcome of the study was determined at a p-value < 0.05, along with a 95% confidence interval for the variables. The patients were within the average age of 38.6(standard deviation ± 12.5) years and majority (45.57%) had no formal education. The overall death incidence rate among second-line anti-retroviral treatment patients was 1.98 per 100-person years [95% CI 1.4—2.9%]. Poor adherence to antiretroviral treatment, male gender, and being underweight significantly increased the hazard of death. Conversely, increased anti-retroviral treatment duration had a significant and negative impact, reducing the hazard of death among patients. The study reveals a high incidence of death among second line anti-retroviral treatment users. Independent predictors include poor adherence, male gender, and underweight status, all significantly increasing the risk of death. On the positive side, the hazard of death decreases with longer anti-retroviral treatment duration. A critical concern and counseling should be given for better ART adherence, to change their nutritional status and for males

Prevalence of inadequate intake of micronutrients among school adolescent girls in Meshenti town, 2020.

Prevalence of inadequate intake of micronutrients among school adolescent girls in Meshenti town, 2020.</p

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Proportion of food groups consumed by school adolescent girls in Meshenti town, 2020.

Proportion of food groups consumed by school adolescent girls in Meshenti town, 2020.</p

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Sociodemographic/economic characteristics of school adolescent girls in Meshenti town Bahir Dar City Administration, 2020 (n = 401).

Sociodemographic/economic characteristics of school adolescent girls in Meshenti town Bahir Dar City Administration, 2020 (n = 401).</p

Mean (±SD) and median (IQR) of micronutrient intake of adolescent girls at Meshenti town, Bahir Dar City Administration, February 2020. (n = 401).

Mean (±SD) and median (IQR) of micronutrient intake of adolescent girls at Meshenti town, Bahir Dar City Administration, February 2020. (n = 401).</p

Environmental influence, personal and dietary related characteristics of school adolescent girls in Meshenti town, Bahir Dar City Administration, 2020. (n = 401).

Environmental influence, personal and dietary related characteristics of school adolescent girls in Meshenti town, Bahir Dar City Administration, 2020. (n = 401).</p

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